Sequencing trait-associated mutations to clone wheat rust-resistance gene YrNAM

Stripe (yellow) rust, caused by Puccinia striiformis f. sp. tritici (Pst), can significantly affect wheat production. Cloning resistance genes is critical for efficient and effective breeding of stripe rust resistant wheat cultivars. One resistance gene (Yr10CG) underlying the Pst resistance locus Yr10 has been cloned. However, following haplotype and linkage analyses indicate the presence of additional Pst resistance gene(s) underlying/near Yr10 locus. Here, we report the cloning of the Pst resistance gene YrNAM in this region using the method of sequencing trait-associated mutations (STAM). YrNAM encodes a non-canonical resistance protein with a NAM domain and a ZnF-BED domain. We show that both domains are required for resistance. Transgenic wheat harboring YrNAM gene driven by its endogenous promoter confers resistance to stripe rust races CYR32 and CYR33. YrNAM is an ancient gene and present in wild wheat species Aegilops longissima and Ae. sharonensis; however, it is absent in most wheat cultivars, which indicates its breeding value.

The Emergence of Fusarium oxysporum f. sp. apii Race 4 and Fusarium oxysporum f. sp. coriandrii Highlights Major Obstacles Facing Agricultural Production in Coastal California in a Warming Climate: A Case Study

Currently, Fusarium oxysporum f. sp. apii (Foa) race 4 in celery and F. oxysporum f. sp. coriandrii (Foci) in coriander have the characteristics of emerging infectious plant diseases in coastal southern California: the pathogens are spreading, yield losses can be severe, and there are currently no economical solutions for their control. Celery, and possibly coriander, production in these regions is are likely to have more severe disease from projected warmer conditions in the historically cool, coastal regions. Experimental evidence shows that Foa race 4 causes much higher disease severity when temperatures exceed 21°C. A phylogenomic analysis indicated that Foa race 4, an older, less virulent, and uncommon Foa race 3, and two Foci are closely related in their conserved genomes. These closely related genotypes are somatically compatible. Foa race 4 can also cause disease in coriander and the two organisms readily form "hetero" conidial anastomosis tubes (CAT), further increasing the likelihood of parasexual recombination and the generation of novel pathotypes. A horizontal chromosome transfer event likely accounts for the difference in host range between Foci versus Foa races 4 and 3 because they differ primarily in one or two accessory chromosomes. How Foa race 4 evolved its hyper-virulence is unknown. Although the accessory chromosomes of Foa races 3 and 4 are highly similar, there is no evidence that Foa race 4 evolved directly from race 3, and races 3 and 4 probably only have a common ancestor. Foa race 2, which is in a different clade within the Fusarium oxysporum species complex (FOSC) than the other Foa, did not contribute to the evolution of race 4, and does not form CATs with Foa race 4; consequently, while inter-isolate CAT formation is genetically less restrictive than somatic compatibility, it might be more restricted between FOSC clades than currently known. Other relatively new F. oxysporum in coastal California include F. oxysporum f. sp. fragariae on strawberry (Fof). Curiously, Fof "yellows-fragariae" isolates also have similar core genomes to Foa races 4 and 3 and Foci, perhaps suggesting that there may be core genome factors in this lineage that favor establishment in these soils.

A METHOD TO IDENTIFY AND LOCALIZE A SINGLE HOT PARTICLE IN THE LUNGS USING AN ARRAY OF HIGH-PURITY GERMANIUM DETECTORS FOR IMPROVED ESTIMATE OF THE DEPOSITED ACTIVITY

A new method has been developed to identify and localize a single hot particle in the lungs using an array of four high-purity germanium detectors. The method is based upon calculating a set of three count rate ratios (generated by each individual detector in the array) that are evaluated in sequence to designate whether the measured deposition can be associated with a hot particle rather than the default assumption of a uniform activity distribution. Identification and localization of the hot particle are determined from a single in vivo measurement in which detectors are positioned above and below the thorax. The method was tested using an anthropomorphic thorax phantom in which point sources of 241Am, 137Cs and 60Co were individually inserted in the lungs at 15 different locations and were measured using a scanning bed whole-body counter. Depending upon source location and photon energy, a bias of -35% up to +76% could be introduced by falsely assuming a uniform activity distribution in the lungs. This bias would directly translate to an erroneous dose estimate to the lungs. It was demonstrated that by using the appropriate detector efficiencies for the single hot particle, the bias associated with the activity determination is reduced to <10% and ~2% in average.

The Effect of Temperature on Disease Severity and Growth of Fusarium oxysporum f. sp. apii Races 2 and 4 in Celery

Fusarium oxysporum f. sp. apii race 4, which is in F. oxysporum species complex (FOSC) Clade 2, causes a new Fusarium wilt of celery. We compared F. oxysporum f. sp. apii race 4 with race 2, which causes Fusarium yellows of celery and is in FOSC Clade 3. Optimal temperatures for celery yield are 16 to 18°C. Soil temperatures in California celery production areas can range up to 26°C, and the maximal rate of hyphal extension of F. oxysporum f. sp. apii races 2 and 4 in culture are 25 and 28°C, respectively. Here, we compared the effect of temperatures from 16 to 26°C on growth of F. oxysporum f. sp. apii races 4 and 2 in two celery cultivars: Challenger, which is resistant to F. oxysporum f. sp. apii race 2 and susceptible to race 4; and Sonora, which is susceptible to both F. oxysporum f. sp. apii races 2 and 4. Based on linear regressions, as temperature increases, there is an increase in the log of F. oxysporum f. sp. apii race 4 DNA concentration in celery crowns and in the reduction in plant height. Based on logistic regressions, as temperature increases, the incidence of vascular discoloration increases in celery with either F. oxysporum f. sp. apii race 2 or 4 infection. In both cultivars, temperatures of 22°C and above resulted in a significantly (α = 0.05) greater concentration of F. oxysporum f. sp. apii race 4 than race 2 in planta. The concentration of F. oxysporum f. sp. apii race 2 in crowns in 'Challenger' is temperature-independent and comparatively low; consequently, 'Challenger' is, at least partly, resistant rather than tolerant to F. oxysporum f. sp. apii race 2.

Implementation of a triage monitoring program for internal exposure to short-lived radionuclides in Israel-challenges and recommendations

Monitoring internal exposure to short-lived radionuclides is challenging, due to the frequent measurements required. ISO Standard 16 637 and the Swiss Personal Dosimetry Ordinance describe a screening measurement (triage monitoring) conducted in the workplace to identify workers suspected of internal exposure. Based on a previous study that examined the feasibility of using several commonly found radiation monitors in Israel in a triage monitoring program, we conducted a pilot study towards the implementation of triage monitoring in nuclear medicine facilities in Israel. The pilot study was conducted while considering the current Israeli regulations and local safety culture. We implemented the triage monitoring program in three nuclear medicine facilities in Israel, with a total of 55 monitored workers. The pilot study consisted of two stages: a short-term stage conducted in the largest manufacture of radiopharmaceuticals in Israel and a long-term stage in two nuclear medicine departments in Israel. During the first stage of the study, participants were asked to conduct a daily measurement at the end of the workday and send a urine sample to the national internal dosimetry laboratory. The second stage lasted 5 months in a major hospital and 18 months in a regional hospital. The workers were asked to perform the measurement at the end of the shift and send a urine sample if a defined threshold had been crossed. The mean participation rate in the long-term stage (>70%) indicates that implementation of the triage monitoring program could be successful in Israel. Based on the findings of the study, practical recommendations are listed: suitable monitoring devices, allocating a monitoring location, time of measurement, training of the workers, record keeping and coordination with a certified dosimetry laboratory. The pilot study recommendations were submitted to the Israel Institute for Occupational Safety and Hygiene at the Ministry of Labor, Social Affairs and Social Services.

Phylogenomic Analysis of a 55.1-kb 19-Gene Dataset Resolves a Monophyletic Fusarium that Includes the Fusarium solani Species Complex

Scientific communication is facilitated by a data-driven, scientifically sound taxonomy that considers the end-user's needs and established successful practice. In 2013, the Fusarium community voiced near unanimous support for a concept of Fusarium that represented a clade comprising all agriculturally and clinically important Fusarium species, including the F. solani species complex (FSSC). Subsequently, this concept was challenged in 2015 by one research group who proposed dividing the genus Fusarium into seven genera, including the FSSC described as members of the genus Neocosmospora, with subsequent justification in 2018 based on claims that the 2013 concept of Fusarium is polyphyletic. Here, we test this claim and provide a phylogeny based on exonic nucleotide sequences of 19 orthologous protein-coding genes that strongly support the monophyly of Fusarium including the FSSC. We reassert the practical and scientific argument in support of a genus Fusarium that includes the FSSC and several other basal lineages, consistent with the longstanding use of this name among plant pathologists, medical mycologists, quarantine officials, regulatory agencies, students, and researchers with a stake in its taxonomy. In recognition of this monophyly, 40 species described as genus Neocosmospora were recombined in genus Fusarium, and nine others were renamed Fusarium. Here the global Fusarium community voices strong support for the inclusion of the FSSC in Fusarium, as it remains the best scientific, nomenclatural, and practical taxonomic option available.

Horizontal chromosome transfer and independent evolution drive diversification in Fusarium oxysporum f. sp. fragariae

The genes required for host-specific pathogenicity in Fusarium oxysporum can be acquired through horizontal chromosome transfer (HCT). However, it is unknown if HCT commonly contributes to the diversification of pathotypes. Using comparative genomics and pathogenicity phenotyping, we explored the role of HCT in the evolution of F. oxysporum f. sp. fragariae, the cause of Fusarium wilt of strawberry, with isolates from four continents. We observed two distinct syndromes: one included chlorosis ('yellows-fragariae') and the other did not ('wilt-fragariae'). All yellows-fragariae isolates carried a predicted pathogenicity chromosome, 'chrY-frag ', that was horizontally transferred at least four times. chrY-frag was associated with virulence on specific cultivars and encoded predicted effectors that were highly upregulated during infection. chrY-frag was not present in wilt-fragariae; isolates causing this syndrome evolved pathogenicity independently. All origins of F. oxysporum f. sp. fragariae occurred outside of the host's native range. Our data support the conclusion that HCT is widespread in F. oxysporum, but pathogenicity can also evolve independently. The absence of chrY-frag in wilt-fragariae suggests that multiple, distinct pathogenicity chromosomes can confer the same host specificity. The wild progenitors of cultivated strawberry (Fragaria × ananassa) did not co-evolve with this pathogen, yet we discovered several sources of genetic resistance.

A haplotype-phased genome of wheat stripe rust pathogen Puccinia striiformis f. sp. tritici, race PST-130 from the Western USA

More virulent and aggressive races of Puccinia striiformis f. sp. tritici (Pst), the pathogen causing wheat stripe rust, have been spreading around the world since 2000 causing large grain yield losses. A better understanding of the genome and genetic diversity of these new Pst races will be useful to develop new strategies to ameliorate these losses. In this study, we generated an improved genome assembly of a post-2000 virulent race from the Western USA designated as PST-130. We implemented a haplotype phasing strategy using the diploid-aware assembler, Falcon-Unzip and new long-read technology from PacBio to phase the two genomes of this dikaryotic organism. The combination of these new technologies resulted in an improved PST-130 assembly with only 151 contigs (85.4 Mb, N50 of 1.44 Mb), and a complementary assembly (haplotigs) with 458 contigs (65.9 Mb, N50 of 0.235 Mb, PRJNA650506). This new assembly improved gene predictions resulting in 228 more predicted complete genes than in the initial Illumina assembly (29,178 contigs, N50 of 5 kb). The alignment of the non-repetitive primary and haplotig contigs revealed and average of 5.22 SNP/kb, with 39.1% showing <2 SNP/kb and 15.9% >10 SNP/kb. This large divergent regions may represent introgressions of chromosome segments from more divergent Pst races in regions where a complete sexual cycle and recombination are possible. We hypothesize that some of the divergent regions in PST-130 may be related to the European "Warrior" race PST-DK0911 because this genome is more similar to PST-130 (3.18 SNP/kb) than to the older European race PST-104E (3.75 SNP/kb). Complete phasing of additional Pst genomes or sequencing individual nuclei will facilitate the tracing of the haploid genomes introduced by the new Pst races into local populations.

Genomic differences between the new Fusarium oxysporum f. sp. apii (Foa) race 4 on celery, the less virulent Foa races 2 and 3, and the avirulent on celery f. sp. coriandrii

BACKGROUND

Members of the F. oxysporium species complex (FOSC) in the f. sp. apii (Foa) are pathogenic on celery and those in f. sp. coriandrii (Foci) are pathogenic on coriander (=cilantro). Foci was first reported in California in 2005; a new and highly aggressive race 4 of Foa was observed in 2013 in California. Preliminary evidence indicated that Foa can also cause disease on coriander, albeit are less virulent than Foci. Comparative genomics was used to investigate the evolutionary relationships between Foa race 4, Foa race 3, and the Foci, which are all in FOSC Clade 2, and Foa race 2, which is in FOSC Clade 3.

RESULTS

A phylogenetic analysis of 2718 single-copy conserved genes and mitochondrial DNA sequence indicated that Foa races 3 and 4 and the Foci are monophyletic within FOSC Clade 2; these strains also are in a single somatic compatibility group. However, in the accessory genomes, the Foci versus Foa races 3 and 4 differ in multiple contigs. Based on significantly increased expression of Foa race 4 genes in planta vs. in vitro, we identified 23 putative effectors and 13 possible pathogenicity factors. PCR primers for diagnosis of either Foa race 2 or 4 and the Foci were identified. Finally, mixtures of conidia that were pre-stained with different fluorochromes indicated that Foa race 4 formed conidial anastomosis tubes (CATs) with Foci. Foa race 4 and Foa race 2, which are in different somatic compatibility groups, did not form CATs with each other.

CONCLUSIONS

There was no evidence that Foa race 2 was involved in the recent evolution of Foa race 4; Foa race 2 and 4 are CAT-incompatible. Although Foa races 3 and 4 and the Foci are closely related, there is no evidence that either Foci contributed to the evolution of Foa race 4, or that Foa race 4 was the recent recipient of a multi-gene chromosomal segment from another strain. However, horizontal chromosome transfer could account for the major difference in the accessory genomes of Foa race 4 and the Foci and for their differences in host range.

An ancestral NB-LRR with duplicated 3'UTRs confers stripe rust resistance in wheat and barley

Wheat stripe rust, caused by Puccinia striiformis f. sp. tritici (Pst), is a global threat to wheat production. Aegilops tauschii, one of the wheat progenitors, carries the YrAS2388 locus for resistance to Pst on chromosome 4DS. We reveal that YrAS2388 encodes a typical nucleotide oligomerization domain-like receptor (NLR). The Pst-resistant allele YrAS2388R has duplicated 3’ untranslated regions and is characterized by alternative splicing in the nucleotide-binding domain. Mutation of the YrAS2388R allele disrupts its resistance to Pst in synthetic hexaploid wheat; transgenic plants with YrAS2388R show resistance to eleven Pst races in common wheat and one race of P. striiformis f. sp. hordei in barley. The YrAS2388R allele occurs only in Ae. tauschii and the Ae. tauschii-derived synthetic wheat; it is absent in 100% (n = 461) of common wheat lines tested. The cloning of YrAS2388R will facilitate breeding for stripe rust resistance in wheat and other Triticeae species.

Stripe rust is a serious threat to wheat production. Here, the authors reveal that the resistance gene, only present in the wheat progenitor Aegilops tauschii and its derived synthetic wheat, encodes a nucleotide oligomerization domain-like receptor and confers resistance in common wheat and barley.

Cloning of the Cytochrome b Gene From the Tomato Powdery Mildew Fungus Leveillula taurica Reveals High Levels of Allelic Variation and Heteroplasmy for the G143A Mutation

Leveillula taurica is a major pathogen of tomato and several other crops that can cause substantial yield losses in favorable conditions for the fungus. Quinone outside inhibitor fungicides (Q_oIs) are routinely used for the control of the pathogen in tomato fields across California, but their recurrent use could lead to the emergence of resistance against these compounds. Here, we partially cloned the cytochrome b gene from L. taurica (Lt cytb) and searched within populations of the fungus collected from tomato fields across California for mutations that confer resistance to Q_oIs. A total of 21 single nucleotide polymorphisms (SNPs) were identified within a 704 bp fragment of the Lt cytb gene analyzed, of which five were non-synonymous substitutions. Among the most frequent SNPs encountered within field populations of the pathogen was the G143A substitution that confers high levels of resistance against Q_oIs in several fungi. The other four amino acid substitutions were novel mutations, whose effect on Q_oI resistance is currently unknown. Sequencing of the Lt cytb gene from individual single-cell conidia of the fungus further revealed that most SNPs, including the one leading to the G143A substitution, were present in a heteroplasmic state, indicating the co-existence of multiple mitotypes in single cells. Analysis of the field samples showed that the G143A substitution is predominantly heteroplasmic also within field populations of L. taurica in California, suggesting that Q_oI resistance in this fungus is likely to be quantitative rather than qualitative.

Abstract P2-04-02: Comparison of DNA methylation patterns in normal breast tissue from women with and without breast cancer

BACKGROUND: Increasing evidence suggests that epigenetic mechanisms play critical roles in the development of breast cancer. However, precise DNA methylation signatures associated with breast cancer susceptibility remain unknown. We sought to compare DNA methylation changes in the normal breast tissue of women with and without breast cancer to identify patterns of aberrant DNA methylation in women with breast cancer.

METHODS:Samples of normal breast tissue were collected from four cohorts of women: age &lt; 50 years with and without breast cancer, and age ≥50 years with and without breast cancer. Normal breast tissue from healthy women was obtained from the Komen Tissue Bank at IU Simon Cancer Center and from women presenting for reduction mammoplasty at Yale New Haven Hospital. Normal breast tissue from women with breast cancer was obtained from patients undergoing adjuvant total mastectomy at Yale Breast Center. DNA was extracted using Qiagen AllPrep Universal kit. Raw data files in idat format were imported to Partek Genomics Suite 6.6 for normalization and differential methylation analysis. Raw intensities were normalized using With Array Normalization (SWAN) method. Principal component analysis (PCA) were performed as quality control. Differentially methylated loci (DML) between control and breast cancer groups were detected when False discovery rate (FDR) &lt; 0.05 and fold change &gt; 1.5. Functional enrichment analysis of genes with DML in the gene body were conducted using METACORE™. Pathways with FDR &lt; 0.05 were selected.

RESULTS: Ninety-three normal breast tissue samples from 89 subjects were analyzed (breast cancer=40, unaffected=53). Comparison of DNA methylation patterns between women with and without breast cancer revealed 200 DMLs. The majority of DMLs (186) were hyper-methylated in breast cancer patients, and 48 DMLs locate in enhancers of genes. 170 DMLs locate in 134 genes, enriched in two pathways: (1) Cell adhesion_Endothelial cell contacts by junctional mechanisms, and (2) Neurophysiological process_Constitutive and regulated NMDA receptor trafficking. Genes associated with cell adhesion and cell contacts included: ACTN2, GJA4, GJA7 and MAGI1. Two hyper-methylated loci were found in enhancers of ACTN2. In addition, one hyper-methylated locus in GJA4, one hyper-methylated and one hypo-methylated loci in GJA7, and two hyper-methylated loci in MAGI1 were detected in breast cancer patients. Genes associated with NMDA receptor trafficking include: TPK1, ADCY4 and LIN7C. One and two loci were found in TPK1 and ADCY4, respectively, that were hyper-methylated in normal breast tissue from cancer patients in the gene body, while a hypo-methylated locus in breast cancer patients was identified in LIN7C.

CONCLUSIONS: Comparison of DNA methylation patterns of normal breast tissue from women with and without breast cancer reveal specific mechanistic pathways and genes that are differentially methylated in women with breast cancer. DNA methylation of normal breast tissue deserves further study as a potential biomarker for breast cancer risk stratification and may lend new insight into mechanisms of breast cancer development.

Citation Format: Hofstatter EW, Zhu Y, Horvath S, Chagpar AB, Wali VB, Bossuyt V, Storniolo AM, Hatzis C, Patwardhan G, Von Wahlde M-K, Butler M, Epstein L, Stavris K, Sturrock T, Au A, Kwei S, Pusztai L. Comparison of DNA methylation patterns in normal breast tissue from women with and without breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-04-02.

AN ESTIMATION OF THE EXPOSURE OF THE POPULATION OF ISRAEL TO NATURAL SOURCES OF IONIZING RADIATION

The radiation dose to the population of Israel due to exposure to natural sources of ionizing radiation was assessed. The main contributor to the dose is radon that accounts for 60% of the exposure to natural sources. The dose due to radon inhalation was assessed by combining the results of a radon survey in single-family houses with the results of a survey in apartments in multi-storey buildings. The average annual dose due to radon inhalation was found to be 1.2 mSv. The dose rate due to exposure to cosmic radiation was assessed using a code that calculates the dose rate at different heights above sea level, taking into account the solar cycle. The annual dose was calculated based on the fraction of time spent indoors and the attenuation provided by buildings and was found to be 0.2 mSv. The annual dose due to external exposure to the terrestrial radionuclides was similarly assessed. The indoor dose rate was calculated using a model that takes into account the concentrations of the natural radionuclides in building materials, the density and the thickness of the walls. The dose rate outdoors was calculated based on the concentrations of the natural radionuclides in different geological units in Israel as measured in an aerial survey and measurements above ground. The annual dose was found to be 0.2 mSv. Doses due to internal exposure other than exposure to radon were also calculated and were found to be 0.4 mSv. The overall annual exposure of the population of Israel to natural sources of ionizing radiation is therefore 2 mSv and ranges between 1.7 and 2.7 mSv.

Wheat Ms2 encodes for an orphan protein that confers male sterility in grass species

Male sterility is a valuable trait for plant breeding and hybrid seed production. The dominant male-sterile gene Ms2 in common wheat has facilitated the release of hundreds of breeding lines and cultivars in China. Here, we describe the map-based cloning of the Ms2 gene and show that Ms2 confers male sterility in wheat, barley and Brachypodium. MS2 appears as an orphan gene within the Triticinae and expression of Ms2 in anthers is associated with insertion of a retroelement into the promoter. The cloning of Ms2 has substantial potential to assemble practical pipelines for recurrent selection and hybrid seed production in wheat.

Races of the Celery Pathogen Fusarium oxysporum f. sp. apii Are Polyphyletic

Fusarium oxysporum species complex (FOSC) isolates were obtained from celery with symptoms of Fusarium yellows between 1993 and 2013 primarily in California. Virulence tests and a two-gene dataset from 174 isolates indicated that virulent isolates collected before 2013 were a highly clonal population of F. oxysporum f. sp. apii race 2. In 2013, new highly virulent clonal isolates, designated race 4, were discovered in production fields in Camarillo, California. Long-read Illumina data were used to analyze 16 isolates: six race 2, one of each from races 1, 3, and 4, and seven genetically diverse FOSC that were isolated from symptomatic celery but are nonpathogenic on this host. Analyses of a 10-gene dataset comprising 38 kb indicated that F. oxysporum f. sp. apii is polyphyletic; race 2 is nested within clade 3, whereas the evolutionary origins of races 1, 3, and 4 are within clade 2. Based on 6,898 single nucleotide polymorphisms from the core FOSC genome, race 3 and the new highly virulent race 4 are highly similar with Nei's Da = 0.0019, suggesting that F. oxysporum f. sp. apii race 4 evolved from race 3. Next generation sequences were used to develop PCR primers that allow rapid diagnosis of races 2 and 4 in planta.

Abstract PD4-07: Impact of breast density legislation on Hispanic / Latinas in the Northeast, US

Objective: Changes in health care delivery and policies resulting from translational research efforts are intended to benefit a broad segment of the affected population. Yet, uptake of new approaches may not occur at the same level and/or pace in all groups, inadvertently increasing disparities in cancer outcomes. Our objective is to explore the impact of recently enacted legislation associated with routine mammography screening on Hispanic /Latino women living in Connecticut. Background: Breast densities are the non-fat (epithelial and stromal) breast tissue observable on screening mammograms. They are associated with a 4 to 6 fold increase in breast cancer risk and complicate the reading of screening mammograms, resulting in lowered sensitivity. Connecticut (CT) and many other states have enacted legislation requiring supplemental testing to be offered to women with dense breasts. Per CT statute, insurance companies must cover the cost of ultrasound screening of an entire breast/breasts for women with heterogeneously or extremely dense breasts. Additionally, personal information on breast density must be included in the mailed result following a screening mammogram. The intent is to improve early detection in women with dense breasts and to increase awareness of the greater risk of associated with dense breast tissue. Methods: After this law was enacted in 2008, we undertook a large prospective study of mammography screening in community based Hispanic/Latinas. We enrolled women seeking care in primary health care settings in the 4 CT cities with the largest H/L populations. Eligible women were ages 40-75, self-identified as H/L, and had negative history for breast cancer or breast biopsy. With 75% participation for baseline interview and 98% consent for medical record review, we report baseline interview data and mammography results (medical records) over a 2.5 - 4 year follow-up on 668 H/L women, ages 40-79, living in CT at the time of enrollment (2009-2011). Results: The women in this study were mostly foreign or Puerto Rican born (84%), lower socioeconomic status (51% with household incomes less than $10,000 per year; 54% less had than a high school education) than the general population; median age was 51. Nearly half (46.0%) reported no usual care provider. Only 14% reported speaking English "very well". Most women reported that they received a mammogram in the previous year (65.0%). 21.4% of women met the criteria for receiving additional bilateral ultrasound testing due to heterogeneously dense (19.2%) or extremely dense (2.3%) breast tissue on screening mammograms occurring during follow up. Of the 128 women eligible for follow-up ultrasound, 18 (14%) received this exam. Conclusion: Although state law requires patient notification of breast density and insurance coverage for supplementary bilateral ultrasound tests in women with moderate to extremely dense breasts, our results show low uptake in Hispanic/Latino women in CT. In this largely foreign born, English second language population, effective communication regarding breast cancer risk, breast density, and the availability of follow-up ultrasound or other testing may represent a significant cancer care challenge.

Citation Format: Jones BA, Philpotts L, Cooley R, Silber A, Epstein L, Claye E. Impact of breast density legislation on Hispanic / Latinas in the Northeast, US. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr PD4-07.

Host-induced gene silencing inhibits the biotrophic pathogen causing downy mildew of lettuce

Host-induced gene silencing (HIGS) is an RNA interference-based approach in which small interfering RNAs (siRNAs) are produced in the host plant and subsequently move into the pathogen to silence pathogen genes. As a proof-of-concept, we generated stable transgenic lettuce plants expressing siRNAs targeting potentially vital genes of Bremia lactucae, a biotrophic oomycete that causes downy mildew, the most important disease of lettuce worldwide. Transgenic plants, expressing inverted repeats of fragments of either the Highly Abundant Message #34 (HAM34) or Cellulose Synthase (CES1) genes of B. lactucae, specifically suppressed expression of these genes, resulting in greatly reduced growth and inhibition of sporulation of B. lactucae. This demonstrates that HIGS can provide effective control of B. lactucae in lettuce; such control does not rely on ephemeral resistance conferred by major resistance genes and therefore offers new opportunities for durable control of diverse diseases in numerous crops.

Wheat Stripe Rust Resistance Protein WKS1 Reduces the Ability of the Thylakoid-Associated Ascorbate Peroxidase to Detoxify Reactive Oxygen Species

Stripe rust is a devastating fungal disease of wheat caused by Puccinia striiformis f. sp tritici (Pst). The WHEAT KINASE START1 (WKS1) resistance gene has an unusual combination of serine/threonine kinase and START lipid binding domains and confers partial resistance to Pst. Here, we show that wheat (Triticum aestivum) plants transformed with the complete WKS1 (variant WKS1.1) are resistant to Pst, whereas those transformed with an alternative splice variant with a truncated START domain (WKS1.2) are susceptible. WKS1.1 and WKS1.2 preferentially bind to the same lipids (phosphatidic acid and phosphatidylinositol phosphates) but differ in their protein-protein interactions. WKS1.1 is targeted to the chloroplast where it phosphorylates the thylakoid-associated ascorbate peroxidase (tAPX) and reduces its ability to detoxify peroxides. Increased expression of WKS1.1 in transgenic wheat accelerates leaf senescence in the absence of Pst. Based on these results, we propose that the phosphorylation of tAPX by WKS1.1 reduces the ability of the cells to detoxify reactive oxygen species and contributes to cell death. This response takes several days longer than typical hypersensitive cell death responses, thus allowing the limited pathogen growth and restricted sporulation that is characteristic of the WKS1 partial resistance response to Pst.

Radon concentrations in different types of dwellings in Israel

The average radon concentration in Israeli dwellings was assessed by combining the results of a 2006 radon survey in single-family houses with the results of a 2011 radon survey in apartments of multistorey buildings. Both surveys were based on long-term measurements using CR-39 detectors. The survey in multistorey buildings was intended to assess the influence of recent practices in the local building industry on the radon concentrations. These practices include the use of building materials with higher concentrations of the natural radionuclides in the last 20 y than before, as well as the improvement in sealing techniques over that period. Another practice in place since the early 1990 s is the building of a shielded area in every apartment that is known as an RSS (residential secure space). The RSS is a room built from massive concrete walls, floor and ceiling that can be hermetically sealed and is intended to protect its residents from a missile attack. The influence of the above-mentioned features on radon concentrations was estimated by dividing the participating apartments into two groups: apartments in buildings >20 y, built using building materials with low concentrations of the natural radionuclides, regular sealing and without an RSS and apartments in buildings newer than 10 y, built using building materials with higher concentrations of the natural radionuclides, improved sealing and including an RSS. It was found that the average radon concentration in apartments in new buildings was significantly higher than in old buildings and the average radon concentration in single-family houses was significantly higher than in apartments in multistorey buildings. Doses due to indoor radon were estimated on the basis of the updated information included in the 2009 International Commission on Radiological Protection statement on radon.

Endogenous ergothioneine is required for wild type levels of conidiogenesis and conidial survival but does not protect against 254 nm UV-induced mutagenesis or kill

Ergothioneine, a histidine derivative, is concentrated in conidia of ascomycetous fungi. To investigate the function of ergothioneine, we crossed the wild type Neurospora crassa (Egt(+)) and an ergothioneine non-producer (Egt(-), Δegt-1, a knockout in NCU04343.5) and used the Egt(+) and Egt(-) progeny strains for phenotypic analyses. Compared to the Egt(+) strains, Egt(-) strains had a 59% reduction in the number of conidia produced on Vogel's agar. After storage of Egt(+) and Egt(-) conidia at 97% and 52% relative humidity (RH) for a time course to either 17 or 98 days, respectively, Egt(-) strains had a 23% and a 18% reduction in life expectancy at 97% and 52% RH, respectively, compared to the Egt(+) strains. Based on a Cu(II) reduction assay with the chelator bathocuproinedisulfonic acid disodium salt, ergothioneine accounts for 38% and 33% of water-soluble antioxidant capacity in N. crassa conidia from seven and 20 day-old cultures, respectively. In contrast, ergothioneine did not account for significant (α=0.05) anti-oxidant capacity in mycelia, which have lower concentrations of ergothioneine than conidia. The data are consistent with the hypothesis that ergothioneine has an antioxidant function in vivo. In contrast, experiments on the spontaneous mutation rate in Egt(+) and Egt(-) strains and on the effects of 254 nm UV light on mutation rate and conidial viability do not support the hypothesis that ergothioneine protects DNA in vivo.

Fifty years since Silent Spring

Rachel Carson's 1962 Silent Spring exposed both observed and potential environmental and health externalities of the increasing organochlorine and organophosphate insecticide use in the United States post-World War II. Silent Spring was a critical component in a popular movement that resulted in increased regulation and the development of safer pesticides. Most changes in pesticide use in the global north have involved pesticide substitutions, although riskier pesticides remain in use. Many ideas in Silent Spring are compatible with the theory of integrated pest management (IPM), and IPM has been broadly embraced in the United States and internationally as a strategy for achieving least-use and/or least-risk pesticide use in agriculture. IPM is a politically feasible policy that purports to reduce pesticide use and/or risk in agriculture but often does not, except in extreme cases of pesticide overuse that result in negative agricultural/economic consequences for growers.

One fungus, one name: defining the genus Fusarium in a scientifically robust way that preserves longstanding use

In this letter, we advocate recognizing the genus Fusarium as the sole name for a group that includes virtually all Fusarium species of importance in plant pathology, mycotoxicology, medicine, and basic research. This phylogenetically guided circumscription will free scientists from any obligation to use other genus names, including teleomorphs, for species nested within this clade, and preserve the application of the name Fusarium in the way it has been used for almost a century. Due to recent changes in the International Code of Nomenclature for algae, fungi, and plants, this is an urgent matter that requires community attention. The alternative is to break the longstanding concept of Fusarium into nine or more genera, and remove important taxa such as those in the F. solani species complex from the genus, a move we believe is unnecessary. Here we present taxonomic and nomenclatural proposals that will preserve established research connections and facilitate communication within and between research communities, and at the same time support strong scientific principles and good taxonomic practice.

Lifestyle transitions in plant pathogenic Colletotrichum fungi deciphered by genome and transcriptome analyses

Colletotrichum species are fungal pathogens that devastate crop plants worldwide. Host infection involves the differentiation of specialized cell types that are associated with penetration, growth inside living host cells (biotrophy) and tissue destruction (necrotrophy). We report here genome and transcriptome analyses of Colletotrichum higginsianum infecting Arabidopsis thaliana and Colletotrichum graminicola infecting maize. Comparative genomics showed that both fungi have large sets of pathogenicity-related genes, but families of genes encoding secreted effectors, pectin-degrading enzymes, secondary metabolism enzymes, transporters and peptidases are expanded in C. higginsianum. Genome-wide expression profiling revealed that these genes are transcribed in successive waves that are linked to pathogenic transitions: effectors and secondary metabolism enzymes are induced before penetration and during biotrophy, whereas most hydrolases and transporters are upregulated later, at the switch to necrotrophy. Our findings show that preinvasion perception of plant-derived signals substantially reprograms fungal gene expression and indicate previously unknown functions for particular fungal cell types.

Adhesion of Macroconidia to the Plant Surface and Virulence of Nectria haematococca

To study spore attachment of the cucurbit pathogen Nectria haematococca (anamorph, Fusarium solani f. sp. cucurbitae), mutants with adhesion-deficient macroconidia were isolated. The adhesion-deficient mutants were selected after treatment with N-methyl-N' -nitro-N-nitrosoguanidine followed by repeated enrichment for macroconidia which did not attach to polystyrene. Two independently derived mutants produced macroconidia with an approximately 50% reduction in attachment to polystyrene and to zucchini fruits. When macroconidia were inoculated into wounded zucchini fruits, the adhesion-deficient mutants were as virulent as the wild-type strain. However, in disease assays in which macroconidia were deposited onto the surface of unwounded zucchini, the mutants were less virulent than the wild type. Thus, adhesion of N. haematococca macroconidia to its host surface appears to be a virulence factor.

Genetic and Biochemical Characterization of Nectria haematococca Strains with Adhesive and Adhesion-Reduced Macroconidia

A previous study reported the isolation of two mutants (LE1 and LE2) of the plant pathogenic fungus Nectria haematococca (anamorph, Fusarium solani f. sp. cucurbitae) with macroconidia with reduced ability to adhere (Att) to zucchini fruits and polystyrene. The adhesion-reduced-phenotype in LE1 and LE2 macroconidia is temperature sensitive and dependent on the concentration of nutrients. Classical genetic analysis of progeny derived from LE1 identified a mutation in a genetic locus, named Att1. The 90-kDa glycoprotein and macroconidial tip mucilage which were previously associated with the development of adhesion competence in Att macroconidia are specifically associated with macroconidia; neither is produced on microconidia, which are relatively nonadherent. However, macroconidia of both Att and Att strains produce the 90-kDa glycoprotein and the macroconidial tip mucilage.

Initial use of portable monitoring versus polysomnography to confirm obstructive sleep apnea in symptomatic patients: an economic decision model

BACKGROUND

When using portable (level III and level IV) studies to "rule in" obstructive sleep apnea (OSA) in symptomatic patients, the pre-test probability (P) needs to be sufficiently high to minimize patients with negative tests who require full polysomnography.

METHODS

We used a theoretical decision analysis model to assess the pre-test probability above which it would be appropriate to use portable studies to rule in disease in symptomatic patients with suspected OSA. For the base case, we considered a symptomatically sleepy patient referred with a probability of OSA of P. We determined the lower threshold of P appropriate for a clinical algorithm based upon an initial ambulatory study compared to initial diagnosis with PSG by comparing costs using the PSG algorithm with a diagnostic algorithm involving initial assessment with a portable study.

RESULTS

In our base case, the pre-test probability above which portable testing would be less costly than initial diagnostic PSG would be 0.47. When an initial split night study was compared to portable testing, the pre-test probability above which portable testing was more economically attractive was greater (0.68). Values of P, however, varied considerably depending on values of many variables, including costs of diagnostic testing and CPAP compliance.

CONCLUSIONS

Using a decision model, we have developed a theoretical framework to ascertain the pre-test disease probability above which portable studies would be economically attractive as an initial test in the assessment of patients with suspected OSA.

A kinase-START gene confers temperature-dependent resistance to wheat stripe rust

Stripe rust is a devastating fungal disease that afflicts wheat in many regions of the world. New races of Puccinia striiformis, the pathogen responsible for this disease, have overcome most of the known race-specific resistance genes. We report the map-based cloning of the gene Yr36 (WKS1), which confers resistance to a broad spectrum of stripe rust races at relatively high temperatures (25 degrees to 35 degrees C). This gene includes a kinase and a putative START lipid-binding domain. Five independent mutations and transgenic complementation confirmed that both domains are necessary to confer resistance. Yr36 is present in wild wheat but is absent in modern pasta and bread wheat varieties, and therefore it can now be used to improve resistance to stripe rust in a broad set of varieties.

Fusarium solani species complex isolates conspecific with Fusarium solani f. sp. cucurbitae race 2 from naturally infected human and plant tissue and environmental sources are equally virulent on plants, grow at 37 degrees C and are interfertile

In a previous taxonomic study based on multilocus sequencing of Fusarium from clinical specimens and hospital environments, the most common lineage was Fusarium solani species complex group 1 (FSSC 1) which is conspecific with F. solani f. sp. cucurbitae race 2, a pathogen of cucurbit fruits. The aims of our study were to determine if clinical and environmental isolates of FSSC 1 are plant pathogens and members of the same biological species as cucurbit isolates, and to determine if all isolates can germinate, grow and sporulate at 37 degrees C. Isolates from the different sources did not differ in virulence on zucchini fruits. All FSSC 1 isolates were pathogenic and produced more rot than FSSC isolates from plant hosts other than cucurbits. Both mating types were found among isolates from each of the sources, and all isolates were sexually compatible with cucurbit isolates. All isolates germinated, grew and sporulated at 37 degrees C. This is the first report in which plant pathogenicity has been verified for a collection of human clinical isolates. Our data are consistent with the hypothesis that all FSSC 1 isolates, regardless of source, are a single biological species, equally virulent plant pathogens and tolerant of the human body temperature.

Sewage and community shower drains are environmental reservoirs of Fusarium solani species complex group 1, a human and plant pathogen

In two recent studies, clinical isolates in the Fusarium solani species complex (FSSC) were sequenced; one of the most common lineages was FSSC Group 1 (FSSC 1), a phylogenetic species that is synonymous with F. solani f. sp. cucurbitae race 2, a pathogen of cucurbit fruits. FSSC 1 was also identified in sink and shower drains in two hospitals. The environmental sources of FSSC 1 are important for understanding the epidemiology of both human and plant diseases caused by this organism. FSSC 1 was detected in sewage influent at all six tested urban wastewater treatment plants (WWTPs) in California with a concentration ranging from 75 to 413 colony-forming units (cfu) l(-1), a mean of 246 +/- 52 cfu l(-1) and a median of 254 cfu l(-1). During the treatment process, the concentration of FSSC 1 in the solid and liquid fractions diminished. FSSC 1 was detected in five and six of 14 community shower drains by culturing and polymerase chain reaction, respectively, whereas FSSC DNA was detected in all drains. FSSC accounted for 17 +/- 6% (n = 14) of the total fungal DNA in the drains. FSSC 1 was rarely isolated from post-harvest cucurbit fruits and was not found in cucurbit fields in California.

Identification of Fusarium solani f. sp. cucurbitae Race 1 and Race 2 with PCR and Production of Disease-Free Pumpkin Seeds

Fusarium solani f. sp. cucurbitae causes a fruit rot of cucurbits and is classified into two races that are actually distinct species: F. solani f. sp. cucurbitae race 1 (Fsc1) and race 2 (Fsc2). Because Fsc1 and Fsc2 are not easily distinguished morphologically, we developed a polymerase chain reaction (PCR) assay for rapid identification. Taxon-specific primers were designed from translation elongation factor 1-α sequences. Because clean seed is critical for disease control, we conducted experiments to determine if we could predict whether seed would be infected based on a visual rating of the fruit at harvest. In two trials in commercial pumpkin fields, eight fruit in each of four categories were selected: asymptomatic fruit, mildly infected fruit, severely infected fruit but without lesions extending into the seed cavity, and severely infected fruit with at least one lesion extending into the seed cavity. Isolates from both lesions and seed were identified as Fsc1 based on the PCR assay. No infected seed were recovered from fruit in which the surface was lesion-free or in which a lesion extended less than midway through the fruit flesh. Consequently, a rapid, visual inspection and exclusion of symptomatic fruit should be sufficient to obtain uninfected seed, even in infested fields.

Treatment options for type 2 diabetes in adolescents and youth: a study of the comparative efficacy of metformin alone or in combination with rosiglitazone or lifestyle intervention in adolescents with type 2 diabetes

Despite the increased prevalence of type 2 diabetes mellitus (T2DM) in the pediatric population, there is limited information about the relative effectiveness of treatment approaches. This article describes the rationale and design of a National Institutes of Health-sponsored multi-site, randomized, parallel group clinical trial designed to test the hypothesis that aggressive reduction in insulin resistance early in the course of T2DM is beneficial for prolongation of glycemic control, as well as improvement in associated abnormalities and risk factors. Specifically, the trial compares treatment with metformin with two alternate approaches, one pharmacologic (combining metformin treatment with rosiglitazone) and one combining metformin with an intensive lifestyle intervention program. The Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study recruits 800 patients over a 4-yr period and follows them for a minimum of 2 yr and maximum of 6 yr. Patients are 10-17 yr of age, within 2 yr of diagnosis of diabetes at the time of randomization, lack evidence of autoimmunity, and have sustained C-peptide secretion. The primary outcome is time to loss of glycemic control, defined as a hemoglobin A1c >8% for 6 consecutive months. Secondary outcomes include the effect of the alternative treatments on insulin secretion and resistance, body composition, nutrition, physical activity and fitness, cardiovascular risk monitoring, microvascular complications, quality of life, depression, eating pathology, and resource utilization. TODAY is the first large-scale, systematic study of treatment effectiveness for T2DM in youth. When successfully completed, this study will provide critical new information regarding the natural history of T2DM in youth, the benefits of initiating early aggressive treatment in these patients, and the efficacy of delivering an intensive and sustained lifestyle intervention to children with T2DM.

A class Vb chitin synthase in Colletotrichum graminicola is localized in the growing tips of multiple cell types, in nascent septa, and during septum conversion to an end wall after hyphal breakage

Previous complementation of a chitin synthase class Vb null mutant (Colletotrichum graminicola chsA) indicated that the encoded protein is responsible for approximately 30% of the conidial chitin, is essential for conidial wall strength in media with high water potential, and contributes to strength of hyphal tips. We complemented a chsA null mutant with chsA fused to the green-fluorescent protein (sgfp) gene driven by a heterologous constitutively expressed promoter. Comparisons of the strain with the ectopic chsA-sgfp to the wild type indicated that ChsA-sGFP serves the same biological functions as ChsA in that like the wild type, the chsADelta chsA::sgfp (EC) had conidia that did not explode and hyphal tips that did not swell. Confocal microscopy of ChsA-sGFP (EC) cells stained with the membrane stain FM 4-64 (N-(3-triethylammoniumpropyl)-4-(6-(4-(diethylamino)phenyl)hexatrienyl)pyridinium dibromide) indicated that ChsA is localized in the plasma membrane of the following: growing apices of hyphal branches, conidiophores, and falcate and oval conidia; in nascent septa; and in septa that are being converted to an end wall after hyphal breakage. The data support the hypothesis that chsA either directly or indirectly encodes the information for its localization, that ChsA is localized in the plasma membrane, and that the class Vb enzyme produces chitin synthase in multiple cells and after wall breakage.

Fine particles and meteorological conditions are associated with lung function in children with asthma living near two power plants

Fine particles are thought to pose a risk to health, especially for vulnerable groups such as children with asthma. These children are also known to be affected by meteorological and seasonal changes. We assessed the association between air pollution and lung function via peak expiratory flow (PEF), controlling for seasonal changes, meteorological conditions and personal physiological, clinical and sociodemographic measurements, in a panel of schoolchildren with asthma living near two power plants in Israel. Two hundred and eighty-five children with confirmed asthma performed PEF tests and completed a respiratory symptoms diary twice a day. Particulate matter <10 microm in diameter (PM10), particulate matter <2.5 microm in diameter (PM2.5) and meteorological conditions were measured at six fixed stations. Data were analysed using time series analysis-generalized linear model and generalized estimating equations. The models were built under the assumption that any health outcome belongs to a multivariate hierarchical system and depends on meteorological, geophysical and sociocultural variables and pollution factors. No significant differences were found in the demographic (age, gender, mean parental education level, parental smoking habits, place of birth and housing density), physiological (body mass index) and clinical factors (illness severity) between the communities participating in the study. A significant direct effect of PM2.5 on the PEF was found in Ashdod (P=0.000). In Sderot, this effect was through an interaction between PM10 and the sequential day of the year (P=0.000). The main conclusion of this study is that children with asthma are at risk from air pollution and geophysical conditions. Policy makers should take these results into consideration when setting thresholds for environmental protection.

Rootstock Effects on Pistachio Trees Grown in Verticillium dahliae-Infested Soil

ABSTRACT In a field trial in soil infested with Verticillium dahliae, we compared the yield, growth, incidence of symptoms of Verticillium wilt, and mortality of two interspecific hybrid pistachio tree rootstocks (UCBI and PGII) with the standard rootstocks: the V. dahliae-resistant and susceptible Pistacia integerrima and P. atlantica, respectively. After 10 years, the trees were destructively sampled for V. dahliae in the xylem at the graft union. The results indicate that trees on the (P. atlantica 'KAC' x P. integerrima) hybrid UCBI rootstock grew and yielded as well as those on P. integerrima. Trees on the hybrid PGII yielded the least. Analysis of variance and log-linear models indicate that in soil infested with V. dahliae, three associations significantly affect pistachio nut yield. Rootstock affects scion vigor and extent of infection. Third, the extent of infection and scion vigor are inversely associated. Although trees on the P. integerrima rootstock had the highest ratings in a visual assessment of vigor, 65% were infected with V. dahliae in the trunk in the graft region compared with 73% in P. atlantica and 25% in UCBI. Thus, P. integerrima and UCBI have at least one different mechanism for resistance to V. dahliae.

A class V chitin synthase gene, chsA is essential for conidial and hyphal wall strength in the fungus Colletotrichum graminicola (Glomerella graminicola)

The Colletotrichum graminicola tagged mutant T30 has conidia that burst and hyphal tips that swell in media with low osmotic pressure. The disrupted gene in T30 was identified as a class V chitin synthase (CSV) "chsA," which has an open reading frame of 1783 amino acids and two introns that are 52 and 54 bp. C. graminicola has one copy of chsA and no other highly homologous class V CHSs. Reverse transcriptase PCR indicated that the T30 mutant does not express the chsA transcript fragment in the conserved region in CSVs. Complementation of the mutant with chsA indicates that the encoded protein is responsible for approximately 29% of the chitin in conidial walls, is essential for conidial wall strength in media with high water potential and contributes to strength of hyphal tips. Analysis of the aligned deduced amino acid sequences of the 10 fully sequenced CSVs suggests that they are in two subgroups.

Low back pain--a community-based study of care-seeking and therapeutic effectiveness

PURPOSE

To describe care seeking characteristics among low back pain subjects (LBP); to describe the perceived effectiveness of interventions by recipients of care for LBP; and, to discuss the gap between LBP management guidelines and actual practice in primary care.

METHODS

The population consisted of 555 subjects who were recruited from a cross sectional survey of all inhabitants of a small town in Israel. They reported 1 month LBP and were further probed regarding the characteristics of their pain and pattern of care. Data collection was performed by a self-administered questionnaire.

RESULTS

Some form of care was sought by 78.7% of the participants. More than half (58%) visited a physician, 34.4% were prescribed drug therapy, 37.1% attended physical therapy and 28.6% turned to alternative medicine. Participants with severe pain were more likely to seek care. That was demonstrated by all pain measures (e.g. high Roland and Morris disability scores (8.2+/-5.6 vs 4.4+/-4.1), high symptoms frequency (8.9+/-4.1 vs 7.5+/-3.6) and high pain severity scores (5.6+/-2.2 vs 4.5+/-1.7)). The intervention perceived to be most effective was alternative medicine (graded as 'effective' or 'very effective' by 62.8%), followed by therapeutic exercise programmes (56.9%), bed rest (51.9%) and physical therapy (46.8%).

CONCLUSIONS

Individuals reporting severe LBP were more likely to seek care. The treatment utilities perceived to be most effective were alternative medicine and therapeutic exercises, whereas the least effective were physicians' office visits. A gap was found between clinical guidelines and physicians referrals for other therapeutic interventions.

Patterns of pesticide use in California and the implications for strategies for reduction of pesticides

We used the California Pesticide Use Reports to study use of fungicides, bactericides, fumigants, and selected insecticides, primarily for vegetable, fruit, and nut production in California from 1993 to 2000. There were no obvious trends in decreased use of most compounds used to treat plant disease. However, growers have rapidly adopted recently introduced "conventional" compounds. There is very limited use of microbial biocontrol agents to control plant disease and no indication of an increase. We used case studies to explore the potential of different strategies to reduce pesticide use or risk. There have been reductions in use of organophosphate insecticides, largely by substitution with pyrethroids. Theoretically, replacement of "calendar spray" pesticide programs with "environmentally driven" programs could reduce pesticide use in years with lower disease pressure, but this assumes that the majority of growers currently use a "calendar spray" program and that growers who use less than recommended by an environmentally driven program would not increase their use.

Incidence of and risk factors for HIV-associated distal sensory polyneuropathy

OBJECTIVE

To assess the incidence of and risk factors for distal sensory polyneuropathy (DSP) in a cohort of HIV-infected subjects.

METHODS

We followed 272 subjects semiannually for up to 30 months. DSP was diagnosed if subjects had decreased or absent ankle jerks, decreased or absent vibratory perception at the toes, or decreased pinprick or temperature in a stocking distribution. Subjects were further classified at each visit as having asymptomatic DSP (ADSP) (signs only) or symptomatic DSP (SDSP) if, in addition to the neurologic signs, paresthesias or pain was reported.

RESULTS

At baseline, 45% of the subjects did not meet criteria for DSP, 20% met criteria for ADSP, and 35% met criteria for SDSP. Dideoxynucleoside therapy was used by 23% of the patients, and this treatment was independent of their neuropathy status. In longitudinal univariate analyses, history of AIDS diagnoses (hazard ratio [HR] = 1.89; p = 0.02) and lower CD4 cell count (HR = 0.69; p = 0.0006) were risk factors for incident DSP (ADSP or SDSP). However, for incident SDSP only, in addition to history of AIDS diagnoses, mood and neurologic (other than DSP) and functional abnormalities were significant risk factors. Functional abnormalities remained a significant risk factor in a multiple regression analysis. The presence of ADSP and the use of dideoxynucleosides at baseline were not significant risk factors for incident SDSP. The Kaplan-Meier estimate of the 1-year incidence of SDSP was 36%.

CONCLUSION

Subjects with moderate-to-severe immunosuppression from HIV infection commonly have SDSP. However, sex, use of dideoxynucleosides, and presence of ADSP were not significant risk factors for SDSP.